Solidarity, Our Answer to Despair without Hope

The access of the uninsured as well as the insured to the Greek Public Health system – a subject we have come back to again and again. But still, even after changes many remain without any help. Here is a detailed look at what is going on with the uninsured, but also what has changed for some of the insured in the health system.

Since 2014 the uninsured obtained access to primary health care with the exception of diagnostic tests and medication (with all of the serious problems that we have described in the past (See here). In 2015 The new government proceeded with partial changes that, in some cases improved the situation. But in some cases the effects were negative. More specifically:

The uninsured were given access to diagnostic tests, but only at public health facilities. There is a long waiting period in these pubic facilities especially at public hospitals, so a lot of patients have returned to us for help. Of course, we are referring to urgent cases that require patients to immediately make a CT scan, MRI, triplex, etc in situations that waiting a month would endanger the life of the patient.

As regards the hospitalization of patients in public hospital, we have seen a great improvement and it is now rare for patients to be charged who shouldn’t be. We do worry that this improvement may be overturned. There is no increase in the budgets of hospitals to help cover the increase in patients. Let’s not forget that we’re talking about 3 million uninsured who depend on the Greek Public Health System for help. Can this be done with budgets reduced by more than 50% since 2009?

As for medicine we note the following:

Since 2014 the uninsured have had access to medicines at the same level of co-pay as the insured. The problem is that the co-pay is 25% together with the difference in brand name drugs as opposed to generics. With the rapid impoverishment of many in Greece, it becomes difficult for many to pay even this subsidized price for medications.

For those who fall into the category of insured through welfare, and some of the uninsured with minimal economic resources, they speak of COST-FREE access to medication. This does not exist for anyone. True, there is no co-pay required of these patients, but there is a difference between the stated insurance/ price for the medication and the retail price. So, once again the insured and uninsured pay the difference between these two prices. Here is one of the biggest problems. Those that had health booklet for the indigent were able to obtain the medications at public hospitals at no cost. Now they are asked to pay the difference which can sometimes reach tens of euros more expensive. If a patient doesn’t have it to give, he does not have his treatment. This, by itself, is criminal and should be immediately changed

Access to primary health care has been available through PEDY from 2014 as mentioned above. Unfortunately the lack of medical staff is massive. From the moment that the uninsured have access only from public facilities, and not with associated private facilities, we are seeing lengthy waiting times for consultation times with certain specialties. And this will get worse in 2017 as it is likely that a significant number of doctors will withdraw from PEDY (Primary Public Health Clinics) who are now working there under provisional measures. And that comes after more than 50% of doctors left in February 2014 after the “reforms” of EOPYY and PEDY. After provisional measures were implemented, some doctors did return, but by no means most of them. So it seems that it will get worse.

Individuals who do not have a social security number are completely excluded from the system and only, when they have a serious problem, can they resort to the already over-burdened pubic hospitals. Here is something that needs an immediate solution.

We have become the recipients of the despair of a specific category of patients – those with psychological problems. Under the new legal framework they are shuttled from hospital to hospital to obtain medication and are often without greatly needed treatment days at a time, with all that that entails. What is actually happening exceeds human limits. Individuals disabled by psychiatric problems who in accordance with the new ministry decisions continue to depend on public hospitals for their medication – not allowed to access private pharmacies for their neurological medication – bounce back and forth from one hospital to another and meet weak excuses from each of them, such as “This stamp is from another hospital”, or “this is from PEDY”, etc. the result is they end up with a volunteer community clinic in distress and with a lot of anxiety.

We directly appeal that all these inequities be dealt with immediately. It is time for the Greek Ministry of Health provide cost-free access of the uninsured to the Public Health System, and not just talk about it.

The examples above illustrate, yet once again, that the goal is to transfer the cost of medical care to the patients (a clear policy of the memorandum austerity policies) with total disregard for the needs of specific patients who may not be able to meet these costs.

Unfortunately, there is still reason for the volunteer community clinics to exist. And we have to reshape our strategy so as to not be a crutch for a system that is collapsing and looking for an alibi.

We will continue to fight for a free, unfettered and cost free access for the uninsured to the Greek Public Health system. We will be directing as many patients as possible to public health facilities while monitoring the system’s claims of upgraded services. At the same time we will be pulling back on direct medical services and doctors visits where we can, providing our patients are properly seen to. But we will be enhancing drug delivery to those who cannot afford them. All of this will take place against certain income criteria, but also in the context of the rights and needs of our patients.

None of us should be complacent in a Greece that is in its 6th year of austerity and is experiencing intensifying social inequality. Solidarity is the strongest weapon we have. And it is solidarity that will bring about the much needed reversal that is so needed in our country.